Drug Dependent Red Cell Antibodies and Intravascular Haemolysis Occurring in Patients Treated with 9 Hydroxy‐Methyl‐Ellipticinium

Abstract

Eleven patients were treated weekly with a new cytostatic [and antineoplastic] drug, 9 hydroxy-methyl-ellipticinium (9 HME). Eight were treated for longer than 4 wk; 3 of these developed a drug dependent antibody reacting with normal red blood cells. In 2 of these patients acute intravascular hemolysis occurred, one with oliguric renal failure; in the 3rd patient the drug was stopped as soon as the antibody was detected. In all 3 patients the antibody developed after 4 wk of treatment; it was IgM, agglutinated normal red cells and bound complement only in the presence of the drug. No antibodies could be detected in the patient''s serum reacting with normal platelets in the presence of the drug. The incidence of hemolysis with this drug is much higher than seen with other drugs causing immune-complex hemolysis. Studies done with closely related substances suggest that the antigenic site of the drug is related to the group attached to C atom 9.